Cost of nurse visit by state

What is a nurse visit?

A nurse visit is an alternative to a regular visit with a higher level healthcare provider. Nurse visits are an alternative for problems that are simple and don’t require the detailed evaluation of a doctor. Nurse visits are also appropriate for follow-up when the doctor has already outlined the plan of care. 

Examples of visits that may be nurse visits include:

• Strep throat tests
• Urinary tract infections
• Ear wax removal
• Pregnancy testing
• Removal of stitches or staples
• Birth control injections
• Vaccines
• TB testing
• Height and weight checks
• Lab draws
• Dressing changes
• Blood pressure checks

It is required that the physician be present in the office during a nurse visit even though you do not see them. This ensures that they are available if the nurse determines your problem should be examined by a doctor.

What happens at a nurse visit?

What happens during a nurse visit will depend on why the visit was scheduled. Often you’ll have your vital signs taken (blood pressure, heart rate, temperature, weight), and then you’ll talk to either a nurse or medical assistant about why you are there. If your problem requires testing, such as a strep test or urine check, the nurse will collect a specimen and perform the testing. The nurse may speak to the doctor about your testing, or many doctors have treatment protocols in place that the nurse can follow. At the end of your visit, you may be scheduled back for another nurse visit or follow-up with your primary provider.

What is a level 1 office visit?

A level 1 office visit refers to the evaluation and management (E/M) code that is reported to your health insurance carrier. This code is 99211. Considered a billing code, the level has to do with the amount of money your provider will be reimbursed for the visit. Level 1 visits are the lowest level. The 99211 code is commonly used for visits that involve patient education, follow-up of ongoing problems, and medication checks. It’s important to remember that if your provider bills a 99211 code, you will still need to pay any co-pays your insurance requires.

What level of office visit may be referred to as a nurse visit?

Level 1 office visits or E/M code 99211 are used as nurse visit codes. Any higher-level codes require a visit with the healthcare provider.

Can you bill a nurse visit for a blood pressure check?

Yes, blood pressure checks may be billed as a nurse visit. However, not all offices charge for this service if they are only checking blood pressure as a courtesy for a patient.

Can you bill a nurse visit with an injection?

Yes, you may be billed for a nurse visit and an injection. Each service that is provided at the visit has a charge associated with it. Therefore, the visit is one charge, and you will see additional charges for any injections or vaccines you received during the visit.